The effects of torture controllability on symptom severity of posttraumatic stress disorder, depression and anger in refugees and asylum seekers: A path analysis

Refugees and asylum seekers are exposed to extreme violations of human rights. Among these traumatic events, torture represents one of the most common types of trauma exposure experienced by refugees and asylum seekers.... [ view full abstract ]

Refugees and asylum seekers are exposed to extreme violations of human rights. Among these traumatic events, torture represents one of the most common types of trauma exposure experienced by refugees and asylum seekers. Studies have demonstrated that there is a high correlation between torture exposure and poor mental health outcomes, including greater symptoms of posttraumatic stress disorder (PTSD), depression, anger, and somatic complaints. Despite this, research remains scarce regarding the mechanisms underlying the effects of torture exposure on psychopathology. Theoretical models of PTSD suggest that the uncontrollable nature of a traumatic event, rather than the exposure to trauma itself, influences the development and maintenance of PTSD. This study therefore explored the relationship between torture controllability, emotional responses during torture, and long-term symptoms of PTSD, depression and anger. Data was collected from a convenience sample of 108 adult refugees and asylum seekers in treatment at two psychiatric clinics in Zurich and Bern, Switzerland. A path analysis revealed that torture controllability was negatively associated to PTSD, depression and anger. Furthermore, the effects of torture controllability on psychological symptoms were mediated by anger, but not fear, responses during torture. The present findings provide support for the notion that the uncontrollability, and not the frequency, of torture exposure contribute to the expression of psychopathological symptoms in the long-term.